08 Jan How Nerve Pain Is Diagnosed and Treated at a Pain Management Clinic
Living with nerve pain can feel confusing and exhausting. Symptoms are often described as burning, electric, tingling, or shooting sensations, and they do not always follow a clear pattern. Because nerve pain is complex, finding meaningful relief usually requires more than simply masking symptoms.
At Principal Spine & Pain Consultants, our approach focuses on identifying the most likely source of neuropathic pain and then building a targeted treatment plan designed to improve comfort, function, and quality of life.
Why Nerve Pain Often Requires a More Precise Diagnosis
Nerve pain (also called neuropathic pain) can sometimes mimic other conditions. For example, pain in the leg may be caused by:
- A pinched nerve in the spine (often called sciatica)
- Irritation in the sacroiliac (SI) joint
- Joint inflammation in the lower back
- Nerve sensitivity following an injury or surgery
When the cause is unclear, patients may go through weeks or months of treatment without lasting improvement. This is sometimes referred to as “treatment fatigue,” when it feels like nothing is working and the next step is uncertain.
A pain management clinic can help by using advanced diagnostic methods to narrow down where symptoms are coming from.
A Clarity-First Approach to Nerve Pain
Nerve pain treatment is most effective when it is based on clinical evidence, not guesswork. At Principal Spine & Pain Consultants, we often start by confirming which structure is most likely responsible for symptoms before recommending long-term treatment.
Depending on your symptoms, imaging, and exam findings, your provider may recommend specialized diagnostic tools.
Diagnostic Tools That Help Identify the Source of Neuropathic Pain
Nerve Mapping and Diagnostic Blocks
Targeted diagnostic injections may help confirm whether a specific nerve, joint, or area of inflammation is contributing to pain. These blocks can also help guide which treatment options are most appropriate.
Provocative Discography
Provocative discography is a specialized test that may be recommended in select cases when back pain does not match what imaging shows. It is not used for every patient, and your provider can help determine whether it is appropriate based on your symptoms and health history.
Selective Nerve Root Blocks
A selective nerve root block can help determine whether a specific spinal nerve is responsible for radiating symptoms into the arm or leg. This may be useful when symptoms overlap with other possible pain sources.
Advanced Treatment Options for Nerve Pain
Once the likely source of pain is identified, interventional pain management offers several treatment options. These therapies are often considered a middle ground between conservative care and more invasive surgery.
Your plan may include one or more of the following depending on your diagnosis.
Spinal Cord Stimulation (SCS)
Spinal cord stimulation may be an option for certain patients with chronic nerve pain, including those who continue to have symptoms after spine surgery (sometimes called failed back surgery syndrome).
SCS works by delivering mild electrical signals to modify pain signaling before it reaches the brain. Many patients report improvement in symptoms such as burning, tingling, or radiating pain, especially in the legs.
SCS is not appropriate for everyone, and results vary. In many cases, patients may be eligible for a trial first, which helps determine whether this treatment may provide meaningful benefit.
IV Ketamine Infusions
In some cases of treatment-resistant nerve pain, IV ketamine infusions may be considered. Ketamine is different from traditional pain medications. It works on specific receptors in the brain and nervous system that are involved in pain signaling.
Ketamine therapy is not used for every type of pain and is not a first-line treatment. Your provider can discuss whether it may be appropriate based on your diagnosis, medical history, and response to other therapies.
Nerve Blocks and Radiofrequency Ablation (RFA)
Some nerve-related pain is linked to irritated spinal joints or small nerve branches that transmit pain signals. In those cases, nerve blocks may be used to confirm the pain source.
If diagnostic blocks suggest a specific area is contributing to pain, radiofrequency ablation may be recommended. RFA uses controlled thermal energy to interrupt pain signaling from targeted nerves.
Many patients experience longer-lasting relief than with standard injections, although the duration and degree of improvement vary by individual.
Patient Comfort and Sedation Options
It is normal to feel anxious about procedures involving the spine or nerves. Some patients worry about discomfort, needles, or past experiences with injections.
At Principal Spine & Pain Consultants, Dr. Paul Kurian offers sedation and anesthesia options for interventional treatments. This may help reduce stress and improve comfort during procedures, especially for patients who feel nervous or have difficulty tolerating injections.
Your provider will review your health history and help determine whether sedation is appropriate and safe for you.
Moving Forward With Nerve Pain in North Texas
Whether you live in Carrollton, Denton, or the surrounding North Texas area, nerve pain can interfere with nearly every part of daily life. Many patients seek care not only to reduce pain, but to return to activities that matter, such as:
- Working comfortably
- Sleeping more consistently
- Walking longer distances
- Exercising safely
- Spending time with family without constant flare-ups
If you have been through multiple treatments without clear answers, a pain management clinic may be able to offer a more targeted approach focused on diagnosis and evidence-based options.
Disclaimer
This information is general and for educational purposes only. It does not substitute professional medical advice, diagnosis, or treatment. Always talk with a qualified healthcare provider about your symptoms and health history.
Ready to Find the Source of Your Nerve Pain?
If you are managing ongoing nerve pain, back pain, or radiating symptoms into the arms or legs, a consultation can help clarify what may be contributing to your discomfort.